Black Californians make up only 7% of the states population, but make up more than 25% of the state's population of people who experience homelessness. The number is higher in Sacramento County, where 31% of the population experiences homelessness. The obstacles to housing, employment, income and health care that Black Californians have historically faced are also among the pathways to homelessness. "The situation for unhoused Black Californians is dire, but it is not insurmountable,” said Tiana Moore, PhD, the report’s co-author.

This UCSF study examined whether permanent supportive housing reduces the use of acute health care and other services among people experiencing chronic homelessness. The Permanent Supportive Housing program intervention was able to house 86% of chronically homeless adults randomized to the treatment group based on their high use of multiple systems. Even the most frequent clients of medical, psychiatric, and emergency services were housed successfully, as demonstrated in this study of Project Welcome Home in Santa Clara County.

This New York Times article reports on increasing deaths among people experiencing homelessness and highlights a recent JAMA Network Open study from BHHI researchers. BHHI faculty members Maria Raven, MD, and Margot Kushel, MD, are quoted.

Safe Ground Sacramento is a nonprofit that advocates for the decriminalization of homelessness and the establishment of Safe Ground communities. In March 2023, Safe Ground Sacramento signed a lease with the city of Sacramento. Under this agreement, the city cannot close Camp Resolution until every resident has been placed in "individual permanent durable housing." The agreement with the city is set to expire in June and the city has decided not to request an extension. This is the fourth installment of a 4 part series exploring solutions to homelessness in California.

California state lawmakers say they need more tools to help get people experiencing homelessness into treatment, debating the use of involuntary commitments. Homelessness is caused by a lack of affordable housing, not mental illness. “The problem of homelessness is that people don't have housing. If you had all the treatment in the world and you didn't have the housing, we would still have this problem,” said Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative.

Cancer is the leading cause of mortality for people experiencing homelessness (PEH). However, not much is known about cancer-related surgical outcomes among PEH. This retrospective cohort study aimed to characterize access to care among PEH, evaluate postoperative outcomes, and assess costs associated with surgery for malignancy among PEH. Researchers found that PEH were less likely to undergo surgery for malignancy at cancer centers than hose who are housed. People experiencing homelessness also had a higher risk of requiring unplanned surgery.

As the coronavirus alters daily life for many Californians, state leaders are facing the confluence of two public health challenges: the virus and homelessness. “What you are seeing is two crises—homelessness and the virus—collide,” says Margot Kushel, MD, director of the Center for Vulnerable Populations at UCSF.

There is a massive shortage of affordable housing for people with very low incomes in California. Only 24 units of housing are affordable for every 100 extremely low income households in California, compared to 33 units nationally. To address the housing crisis, the statewide study on people experiencing homelessness recommend a variety of policies to increase affordable housing and provide more effort to prevent people from becoming homeless. "This is all about the disconnection between people’s incomes and housing costs" said Margot Kushel, MD, a physician who treats homeless people, and the lead investigator of the study for the UCSF Benioff Homelessness and Housing Initiative.

In this op-ed, Ryan Assaf, PhD, MPH, a postdoctoral fellow with the Benioff Homelessness and Housing Initiative, highlights the benefits of adding Middle Eastern or North African to the US Census. He emphasized the diverse culture in the MENA communities and the importance of separating Middle Eastern or North African from White. "When Middle Eastern or North African is included as White, we lose any insight to the impact MENA communities experience." Dr. Assaf writes. This op-ed was published as part of the Public Voices Fellowship in partnership with The OpEd Project and funding from the California Health Care Foundation.

California is home to 30% of the nation's homeless population, and 50% of the nation's unsheltered population. The UCSF Benioff Homelessness and Housing Initiative released the largest representative study on homelessness in decades. The study's findings dispel common myths and take a systematic approach to understanding the causes of homelessness and potential solutions. Inside the Issues host Alex Cohen speaks with Margot Kushel, MD, director of UCSF’s Benioff Homelessness and Housing Initiative, about the landmark study and the root causes of homelessness. When talking about older people experiencing homelessness, Dr. Kushel said, "The story of homelessness in California is really older adults, usually older adults of color, living their last years on our streets."

Public policy academics Pamela Herd and Don Moynihan have an interesting brief in Health Affairs on how administrative burdens can harm the health of low-income people. Herd and Moynihan quite literally wrote the book on administrative burdens, so their work on the subject is always worth a look.

In this op-ed, Margot Kushel, MD, professor of medicine and director of the Benioff Homelessness and Housing Initiative at UCSF, and Gregg Colburn, Ph.D., an associate professor at the University of Washington, call for providing subsidized housing with services to people experiencing homelessness. They outline the lack of access to housing, the increase in rent, and the ongoing challenge to provide permanent housing. "The answers to homelessness are clear. It is critical that policymakers in local, state and federal governments use their power to address the acute affordable housing shortage that plagues communities in every state in the nation." Dr. Kushel and Dr. Colburn write. This op-ed was published as part of the Public Voices Fellowship in partnership with The OpEd Project and funding from the California Health Care Foundation.

When pandemic aid programs begin expiring at the end of September, advocates worry that San Francisco’s most vulnerable homeless women will once again be left behind. Margot Kushel, MD, discussed the rate of violence impacting homeless seniors, women, and transgender people. After two decades of studying high rates of assault and the health impacts of homelessness, she has watched Bay Area seniors placed into hotels during the pandemic transform, to the point where staff didn’t recognize some of them. “It’s been a life-changing experience,” Dr. Kushel said. “When people regain housing, everything gets better.”

San Francisco and California have been reckoning with the issue of housing instability for years, but additional complexities arise as people experiencing homelessness grow older. In this Grand Rounds, Margot Kushel, MD, one of the world’s leading experts on homelessness, discusses the drivers and precipitants of homelessness and the health consequences of aging in the homeless population. Dr. Kushel is professor of medicine and directs both the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative.

In this Grand Rounds at Dartmouth Medical School, Margot Kushel, MD, one of the world’s leading experts on homelessness, discusses the drivers and precipitants of homelessness, the demographics of homelessness, and the health consequences of aging in the homeless population. Dr. Kushel is a professor of medicine and directs both the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative.

In this UC San Diego Department of Medicine Grand Rounds, Margot Kushel, MD, one of the world’s leading experts on homelessness, discusses why the homeless population is aging, the health consequences of aging in the homeless population, and possible interventions and solutions. Dr. Kushel is professor of medicine and directs both the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative.

Margot Kushel, MD, director of UCSF’s Benioff Housing and Homelessness Initiative, talks about aging, the structural and individual factors that contribute to homelessness, and much more in the GeriPal podcast with Eric Widera, MD, and Alex Smith, MD, MPH, MS. During the conversation, Dr. Kushel said, "I like to say homelessness is a state and not a trait. It’s not an intrinsic quality of a person. It is an experience that they go through."

In this Medical Grand Rounds at the University of Washington, Margot Kushel, MD, a professor of medicine and directs both the UCSF Center for Vulnerable Populations and the UCSF Benioff Homelessness and Housing Initiative, discusses the drivers and precipitants of homelessness, the demographics of homelessness in the United States, the health consequences of aging in the homeless population, and interventions and solutions.